Office-based Magnetic Resonance Imaging–guided Transperineal Prostate Biopsy Without Antibiotic Prophylaxis: A Real-world Clinical Utility Study
Research output: Contribution to journal › Journal article › Research › peer-review
Standard
Office-based Magnetic Resonance Imaging–guided Transperineal Prostate Biopsy Without Antibiotic Prophylaxis : A Real-world Clinical Utility Study. / Boesen, Lars; Nørgaard, Nis; Bisbjerg, Rasmus; Al-Hamadani, Muhammad Munther Nasir; Sjölin, Carl Sebastian; Løgager, Vibeke.
In: European Urology Open Science, Vol. 59, 2024, p. 71-77.Research output: Contribution to journal › Journal article › Research › peer-review
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Office-based Magnetic Resonance Imaging–guided Transperineal Prostate Biopsy Without Antibiotic Prophylaxis
T2 - A Real-world Clinical Utility Study
AU - Boesen, Lars
AU - Nørgaard, Nis
AU - Bisbjerg, Rasmus
AU - Al-Hamadani, Muhammad Munther Nasir
AU - Sjölin, Carl Sebastian
AU - Løgager, Vibeke
N1 - Publisher Copyright: © 2023 The Authors
PY - 2024
Y1 - 2024
N2 - Background and objective: Advances in for magnetic resonance imaging (MRI)-guided transperineal biopsy (TPBx) techniques have facilitated outpatient prostate biopsies under local anaesthesia to lower postbiopsy infection rates. However, there is debate regarding antibiotic prophylaxis because of concerns regarding antibiotic resistance and interactions. Our objective was to assess the transition from office-based transrectal biopsy to TPBx performed under local anaesthesia without antibiotic prophylaxis despite potential risk factors for infectious complications. Methods: We conducted a prospective assessment of 665 men undergoing office-based MRI-guided TPBx. The primary outcome was the rate of urosepsis or febrile urinary tract infections requiring hospitalisation and/or antibiotics within 2 wk after biopsy. Secondary outcomes included patient-reported procedure tolerability and the prostate cancer detection rate. Key findings and limitations: TPBx using a median of nine cores per patient (range 4–15) detected prostate cancer in 534/665 men (80%). Only four men (0.6%) were hospitalised for suspected postbiopsy infection; no patient experienced urosepsis. The TPBx procedure was well tolerated, with low pain scores (median Visual Analogue Scale score of 2, interquartile range [IQR] 1–3) and positive patient ratings (median rating 1 [no problem], IQR 1–2). Limitations include the single-centre analysis and lack of randomisation for antibiotic prophylaxis. Conclusions and clinical implications: An office-based TPBx strategy under local anaesthesia without antibiotic prophylaxis is well tolerated and has a very low risk of side effects. This approach should be considered as the standard of care. Further studies may determine if a subgroup of predisposed men could benefit from antibiotic prophylaxis. Patient summary: For prostate biopsy the sampling needle can be inserted through the rectum or through the perineum, which is the skin between the rectum and the scrotum. Our study confirms that in everyday clinical practice, prostate biopsy via the perineum can be carried out under local anaesthetic and without routine use of antibiotics because of its lower risk of infection. Patients reported low pain scores and positive ratings for the overall experience.
AB - Background and objective: Advances in for magnetic resonance imaging (MRI)-guided transperineal biopsy (TPBx) techniques have facilitated outpatient prostate biopsies under local anaesthesia to lower postbiopsy infection rates. However, there is debate regarding antibiotic prophylaxis because of concerns regarding antibiotic resistance and interactions. Our objective was to assess the transition from office-based transrectal biopsy to TPBx performed under local anaesthesia without antibiotic prophylaxis despite potential risk factors for infectious complications. Methods: We conducted a prospective assessment of 665 men undergoing office-based MRI-guided TPBx. The primary outcome was the rate of urosepsis or febrile urinary tract infections requiring hospitalisation and/or antibiotics within 2 wk after biopsy. Secondary outcomes included patient-reported procedure tolerability and the prostate cancer detection rate. Key findings and limitations: TPBx using a median of nine cores per patient (range 4–15) detected prostate cancer in 534/665 men (80%). Only four men (0.6%) were hospitalised for suspected postbiopsy infection; no patient experienced urosepsis. The TPBx procedure was well tolerated, with low pain scores (median Visual Analogue Scale score of 2, interquartile range [IQR] 1–3) and positive patient ratings (median rating 1 [no problem], IQR 1–2). Limitations include the single-centre analysis and lack of randomisation for antibiotic prophylaxis. Conclusions and clinical implications: An office-based TPBx strategy under local anaesthesia without antibiotic prophylaxis is well tolerated and has a very low risk of side effects. This approach should be considered as the standard of care. Further studies may determine if a subgroup of predisposed men could benefit from antibiotic prophylaxis. Patient summary: For prostate biopsy the sampling needle can be inserted through the rectum or through the perineum, which is the skin between the rectum and the scrotum. Our study confirms that in everyday clinical practice, prostate biopsy via the perineum can be carried out under local anaesthetic and without routine use of antibiotics because of its lower risk of infection. Patients reported low pain scores and positive ratings for the overall experience.
KW - Infection
KW - Magnetic resonance imaging
KW - Prostate biopsy
KW - Prostate cancer
KW - Transperineal imaging-guided biopsy
U2 - 10.1016/j.euros.2023.12.002
DO - 10.1016/j.euros.2023.12.002
M3 - Journal article
C2 - 38298768
AN - SCOPUS:85181010184
VL - 59
SP - 71
EP - 77
JO - European Urology Open Science
JF - European Urology Open Science
SN - 2666-1691
ER -
ID: 388825590